Carbon Dioxide Laser Deroofing for Hidradenitis Suppurativa: Experience from an Asian Cohort.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit associated with recurrent flares, which significantly impair quality of life. Carbon dioxide (CO2) laser deroofing is a tissue-sparing technique that may offer effective symptom control with low recurrence. Our study describes the clinical characteristics and outcomes of an Asian cohort who underwent CO2 laser deroofing for HS. METHODS: This retrospective study included patients who underwent clinic-based CO2 laser deroofing for HS lesions between November 2017 and December 2024 at a single institution. RESULTS: A total of 43 procedures were performed on 30 patients (57% male; median age: 22.0 years [IQR: 17.0-33.8 years]). The cohort included mainly Chinese (53.3%) and Indian (33.3%) patients. At surgery, 51.2% had Hurley stage II disease, 25.6% had stage III disease, and 23.3% had stage I disease. Most patients (95.3%) were concurrently treated with tetracyclines. The axilla was the most treated site (63%). Recurrence occurred in 9.3% of procedures, for which one required abscess aspiration. Other complications included minor bleeding (23.3%), hypergranulation (7.0%), and infection (4.7%). CONCLUSION: CO2 laser deroofing is a simple, effective, and minimally invasive treatment for HS lesions. It offers low recurrence and complication rates and is feasible in an outpatient setting for Asian populations.